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What criteria are you using for retreatment with Pluvicto (Lu-177) in those who maintain a good performance status and appropriate lab work?

This question is part of our collaboration with ASTRO to highlight impactful data from the 2026 Multidisciplinary Radiopharmaceutical Symposium. This question is inspired by the Plenary Session Presentation "Radiopharmaceutical Retreatment" by Dr. Andrew L. Salner
3 Answers
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Radiation Oncology · Corewell Health
Answered on

Mainly, whether or not they've exhausted standard options. At the time I'm answering this, Pluvicto is approved for castration-resistant metastatic disease, either pre- or post-taxane chemotherapy. If they have not had chemo, I usually recommend it. If they have, I get their medical oncologist to we...

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Radiation Oncology · Johns Hopkins University School of Medicine
Answered on

The criteria for re-treatment are not yet established, but prospective trials such as RE-LuPSMA (NCT06288113) are underway. Published data from several institutions suggest potential prediction of good re-treatment response in patients with a favorable response to the first regimen of Lu-PSMA, often...

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Radiation Oncology · Quillen VA Medical Center
Answered on

Pluvicto has the largest use in quite advanced disease. Likely its best use will be in earlier relapse, low bulk.

PSA rise either post-prostatectomy (usually earlier) or post XRT (+/- ENI) leads to a PSMA scan. Some grossly disseminated, with ADT or C likely. Other scans may show uptake in the fossa...

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